Provider Demographics
NPI:1821531518
Name:MEYERS, ALYSSA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 ED ENGLISH DR BLDG 3
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8020
Mailing Address - Country:US
Mailing Address - Phone:936-203-1772
Mailing Address - Fax:
Practice Address - Street 1:250 ED ENGLISH DR BLDG 3
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8020
Practice Address - Country:US
Practice Address - Phone:936-203-1772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72648101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health